Can small steps result in big changes? Preliminary effectiveness of a community-based diabetes prevention program


Efficacy trials use highly controlled designs under "ideal conditions". Once demonstrated, interventions can be translated into the community and the "real-world" effectiveness is examined to optimize their potential public health impact. Small Steps for Big Changes (SSBC) is a diabetes prevention program that has been translated into the community and is currently being run out of the local YMCA. SSBC is a theory-based three-week program consisting of one-on-one exercise and diet counselling, and supervised exercise training. The purpose of this study was to evaluate the effectiveness of the community-based SSBC program in reducing a variety of diabetes risk factors six months post-intervention. Participants with prediabetes (N=90, 71% female, Mage = 42.7 ± 5.6 years) completed the following measures pre-, post- and six months post-program: self-report physical activity and food frequency measure, weight, waist circumference, and a six-minute walk test. From pre-program to six-months post-program: Weight decreased (?-3.37kg), waist circumference decreased (?-4.19cm), and six-minute walk distance increased (?+6.8%). There were significant improvements observed in self-reported physical activity and food frequency. The effects observed from pre- to the six-month post-program were small to moderate (Cohen's ds from .14 to .56). Preliminary evaluation suggests that the SSBC counselling program is effective at promoting diet and physical activity behaviours to help reduce their risk of developing type 2 diabetes. Continued evaluation is required to determine whether the community-based SSBC program produces changes in clinically relevant outcomes (i.e., A1C) one year following the three-week program.

Acknowledgments: Diabetes Canada and Michael Smith Foundation for Health Research postdoctoral awards